Case:Khantje
Khantje born in May 2003, diagnosed Diabetic August 2011, we are getting more experienced and he has done well. Khan was 4 months when he came to live with us. A bit of a problem child, but he is lovely; he had diarrhoea for the first 3 months, always has his 3rd eyelids show. And he had gingivitis which meant we had to take most of his teeth out when he was about 3. Also he has a habit of pulling out his hair. He is a timid 'only child' cat, but over the years has become very affectionate to his mum and dad. He talks a lot, he is my alarm clock in the early mornings and I love him more than anything. Spring 2011 inflamed gums around his top left fang, I hoped the vet could pull it out; unfortunately it broke off. He had a dexafort (anti-inflammatory) and convenia (antibiotic) injection. We brush his teeth every day; he does it mostly himself. Khan also likes to chew on his horse brush and bite feathers and ropes, which all helps to keep his gums healthy. Summer 2011 Khan started to show signs like eating and drinking lots, loosing weight (more than a kilo) and loss of muscle power in hind legs. He was diagnosed with diabetes 22 Aug. 2011 and prescribed Caninsulin 40. You start with quarter unit per kilo of cat: Khan weighed only 3.75 by then - down from 5+. So we started at 1 unit, then 2.. After 2 weeks treatment glucose was 21 mmol/l and we put dosage up to 3 i/u BID (twice a day). That was the turning point; the glucose level dropped too much, so down to 2.5 i/u, which seemed ok for time being. A couple of weeks later Khan was having diarrhea and vomiting, so I skipped a dose and took it down to 2 i/u. My vet said I could have just continued normal dose, but please don't leave your cat out of sight if you think he or she has tummy upset and you have shot him. I learned at Christmas. I use a FreeStyle Lite Blood Glucose tester, trial and error; I pricked myself, my husband, missed, got too much blood and felt terrible about hurting the cat; not easy to stay calm and confident. Over time practice makes perfect. Khan is patiently playing guinea-pig, sometimes with a little squeak of protest: 'Please don't take all bloody day'. Khantje is frantic of going out in the car to the vet. There is no point leaving him at the vet for a full day glucose curve, as seems to be the norm; that would give a day's snapshot of an extremely stressed out animal. Just weekly assessment consultations made him hide for almost a month instead of greeting me at the top of the stairs, like normally when I get home. When it went dark outside and the vet was closed, he would reappear. October - December 2011 7am-7pm 2.2 mmol/l - Khan had 2 slight hypoglycaemia attacks, where I rubbed some honey on his mouth. Other than that, quite stable. Christmas 2011 Khan's diabetes seems almost in remission after another episode of diarrhea, vomiting and a hypo stage 2. Where we acknowledged that hairballs play a big part in this. I hoped for complete remission, but that was short lived, after a week the signs where back. Restarted the treatment with 1/2 i/u BID, when I was sure he had eaten and was not throwing food up. If I am not sure he is digesting his food I skip injecting him rather than taking the risk of a hypo. At hypo stage 2 rubbing honey on his lips was not enough; quickly made him drink diluted honey from a syringe, if you do this, take due care the cat doesn't choke. If your cat is unconscious, you must get the animal to the vet as quick as you can and pray. I was lucky and got him back on his feet by calmly stroking him and talking sweet nonsense speak. Few minutes later carefully picked him up and took him to his food bowl in the kitchen, he still seemed blind for a couple of minutes, then Khan started eating and was back to normal; asking what all the fuss was about! You can calculate approx. when the lowest glucose level is, observe and make sure you are prepared. For example, I inject at 7am, and the level goes right down approx. 10-11am, so 3-4 hours later. Caninsulin has 2 kinds of insulin in it a quick acting and a slower acting. Approx. 3 hours is the quick acting glucose low for Khan, of course every cat is different. January 2012 - The home glucose testing has proven to be vital. Make sure cat is relaxed and the ear is warm. Khan is a lapcat, loves his mummy. We cuddle and at the same time I make sure that I have him in a firm grip, caught between my big arms and legs. I try to think of hemming, which I learned at a very young age; works a treat. I am very privileged that Khan trusts me. He must do, because he is a proud Siamese when it comes to it and if he was bothered, he would swear and rip me to bits. Slowly his digestion is improving, but also the glucose level is creeping up: 9 Jan. 17:45 I measured 14.8 mmol/l For cats with fussy tummies, cat grass might be nice, Khan loves it. 15 Jan. 17:45 up to 18.7 mmol/l. Increased dosage to 1 i/u BID. During the week Khan was not very bright, but happy to be with me, having a play and eating ok. Latter part of week, drinking increased, coat looking more greasy, hind legs and shoulders looked less muscely and we could sense the 'lethargy' of high bloodsugar. 21 Jan. 15:00 blood glucose 16.2, 18:30 blood glucose 20.7 - Increase dosage to 2 i/u BID 22 Jan. 10:30 glucose 10.8, we are happy with this and we will do more tests at mutually convenient times. Right now Khan cat is sleeping next to me on his down duvet, far to content to be disturbed. Next day we found another hairball. We need to give it a few days to adjust to dosage, see how it goes. 9 Feb. All good on 2 i/u BID for a week 17 Feb. Sorry I left the testing for 3 weeks; far too long... 10am - blood glucose 1.8 so I give him some honey and food; result 10:30 - BG 3.2 , 17:30 - BG 9.3. Down to 1.5i/u BID 18 Feb After giving him 1.5 i.u at 7am: 10am - BG 4.5 Then suprise at 19:15 BG 4.7: no insulin pm 19 Feb insulin dosage down to 0.75 i/u BID the drop in BG level +3hr is a bit of a problem. 21 Feb Tested BG after coming home from work before feed: 17:30 - BG 6.7 Gave him good dinner and 0.75 at 18:45. Test at 22:00 showed 2.8 so little honey on mouth and 1 pouch food. 22 Feb -No Insulin- 21:00 BG 9.8 Must say he is more like his old self, fussy with his food. We are not shooting for a few days. But I know that glucose level is going to creep up again. 25 Feb.9:15 - BG 15.2 We give 0.5 i/u pm only I don't want Khan to go into hypo when I am at work, so we stick to 0.5 pm only, but I am not happy with this. Easter 2012 In March we 're-stabilised' the dose to 1 i/u BID , resulting in BG levels between 2 and 11. Demeanour is about right; good old Siamese Fusspot behaviour. This morning I was presented with 2 puked up hairballs; result of eating his furr because off itchy back; long term problem. His weight is approx. 5kg which is right. I do notice slight decline in shoulder muscle, but Khan jumps easely on and of worktops, cupboards, chairs & tables, windowsills, lap and laptop... When he throws up I adjust giving him less insulin, better safe than sorry. 8 April - 14 Aug - Khan is on 1 i/u BID most of the time, some lapses mostly due to puking hairballs up. I am trying to regularly give him a couple of hairball biscuits, or paste. Diet quite constant on Nature's Menu, kitten for breakfast, adult chicken, fish or sometimes beef during the rest of day. Meowing Head biccies, but only as a treat. Sometimes Khan doesn't want to eat, put a few biscuit on top of food and he gobbles it up, all down to smell. MUST test every 2 weeks! Sometimes, like this morning (15/08/12), I can only put it down to 6th sense and good luck that I am with him then he has a hypo. I intended going to work, but as I work as a school-administrator on flexi-time during the Summer holidays, this didn't happen. Anyway around 10:30 Khan went a bit wobbly (according to husband), 10 min. later he started to meow quite persistent at me, sitting in the entrance of kitchen didn't want to move. I watched and saw a tremble going though his body. Not right! Test BG 1.6, smeared honey on his lips and he was hungry ate over half a pouch. Little break, still meow's that sounded like 'help'. Sit with him, bit more food, little honey. OK! Summer 2012 Khan went in remission, but by October we noticed loss in weight and we are testing and juggling between 1/2 and 1 unit. Khantje likes to communicate with his loud voice and cuddle-demeanour and this seems to be a life saver. 'Funny' sounding meows have a distinguished meaning, like: 'Help, don't feel well'. ---- 1 year passes, details to follow ----------- Summer 2013 - It is 1 August and Khan is getting old, loosing weight, puking up food and water, not good.........I test his BG is within margin, try feeding him water with syringe, he is moderate dehydrated and still pukes water, not good... -no more vet-diagnoses- Khan hates the Vet and is too weak to be transported: we know the options... I am his Mum, he loves and trusts me... I am loosing him..... 'No more', he says: 'Please, let me go'. A part of him becomes distant and still we are so close. I stroke him gently, so he tries to sleep. Some liquid every couple of hours, keep him as comfortable as possible...... I can't type right now; look at Mr Khan and how he was on his last birthday............ 6 August 2013 at at 2 pm he died in my arms RequiesCat In Pace, my lovely Category:Feline Caninsulin-Vetsulin users Category:Feline male cases Category:Caninsulin cases